Abstract
Occult HBV infection (OBI), defined by the presence of HBV DNA in absence of hepatitis B surface antigen (HBsAg), is a significant concern in the HIV-infected population. Of 441 HIV+/HBsAg- patients analyzed, the overall prevalence of OBI was 6.3% (28/441). OBI was identified in 21 anti-HBc positives (17.8%), as well as among those who lacked any HBV-specific serological markers (2.2%). Comparison with HIV/HBV co-infection revealed that the levels of CD4, ALT, and HBV DNA were significantly lower during occult infection. Discrete differences were also observed with respect to quasispecies divergence. Additionally, subgenotype D1 was most frequent in occult infection, while D2 was widespread during chronic infection. The majority (~90%) of occult D1 sequences had the sQ129R mutation in the surface gene. This study highlights several distinct features of OBI in India and underscores the need for additional HBV DNA screening in HIV-positive individuals.
Highlights
Hepatitis B virus (HBV) infection continues to be a global health concern despite the presence of an effective vaccine
We evaluated the rate of occult HBV infection (OBI) among the hepatitis B surface antigen (HBsAg) negative/HIVpositive patients of the same cohort. 118 of the 441 human immunodeficiency virus (HIV)-infected individuals evaluated were anti-HBc positive (26.8%). 21 of 118 (17.8%) patients had detectable HBV DNA
Our previous report evidenced high rates of HIV/HBV co-infection (11.3%) in eastern India, which served as the basis for the current cross-sectional study on OBI
Summary
Hepatitis B virus (HBV) infection continues to be a global health concern despite the presence of an effective vaccine. Approximately 2 billion people have been infected with HBV at some stage of life, of them ~248 million are chronic carriers of the virus [1]. Chronic or overt HBV infection is characterized by the presence of hepatitis B surface antigen (HBsAg) in serum for at least six months. Occult HBV infection (OBI) is defined by the presence of HBV DNA in the liver (with detectable or undetectable HBV DNA in the serum) of individuals testing negative for HBsAg by currently available assays [2]. The presence of antibody to hepatitis B core antigen (anti-HBc) has been used previously as a predictive marker for the detection of OBI [2]; OBI occurs in patients who are negative for all HBV serum markers [4,5,6]
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